Doctor of Healing

Chapter 383 Small Probability Events

"Old Lu, the patient's condition..." The director of the Department of Respiratory Medicine didn't say anything, and looked at Lu Gang with a frown.

The ventilator can't move the patient's breath, and the value estimate of the blood gas analysis is particularly poor.

"Director, the blood gas analysis has returned!" A junior doctor rushed in with an A4 paper.

The director of respiratory medicine took a look at the list.

pH: 7.104, PCO2: 89.4mmHg (1mmHg=0.133kPa), PO2: 47mmHg, BE: -2mmol/L, HCO3: 28.0 mmol/L

The data made her feel very tricky, so she handed the list to Lu Gang.

The patient's condition was so poor that the ventilator could hardly move it.

It is not impossible to force a bronchoscopy as Lu Gang said, but there are risks after all, and the most important thing is that there is no definite benefit.

Lu Gang glanced at the test sheet, and subconsciously raised his hand to gather the lock of hair to the top of his head, pretending that he had thick hair.

"Have you studied all the documents issued by the medical office?" Lu Gang asked an irrelevant question.

"What?" The director of respiratory medicine was startled.

"Some time ago, a patient came to complain that the hospital gave him fake medicine." Lu Gang was not in a hurry, looked at the patient's monitor, and began to "gossip".

"..." The director of the Department of Respiratory Medicine didn't know why Lu Gang was talking about this at the critical moment of rescue.

But everyone knew about Lu Gang's diagnostic skills and bad temper, and the director of the respiratory department didn't want to make trouble.

"The patient who complained had to look back every day after defecating, and he didn't know why. Oral Baixintong, let me ask you, what will be in the stool?"

"Bai Xintong's hydrogel shell." The director of the Department of Respiratory Medicine replied.

"I explained it for a long time, but the patient just ignored it. So I drafted it, Director Bai read it and distributed it to each department, mainly in the department of circulatory medicine. In the future, you must explain the pharmacology to the patient and the patient's family when you open Xintong. effect."

"Uh……"

"This patient's oral antihypertensive drug is also Baixintong." Lu Gang said.

The director of the Department of Respiratory Medicine seemed to have remembered something, but he denied the answer in a flash.

"Old Lu, you mean that the patient accidentally inhaled Baixintong into the airway when taking Baixintong orally, and then the shell got stuck?"

"Yes!" Lu Gang's eyes and baldness exuded a slight luster at the same time.

"Impossible!" said the director of the Department of Respiratory Medicine, "If it was Bai Xintong, it wouldn't be so dead..."

"It doesn't matter what I say, prepare the bronchoscope and take a look." Lu Gang waved his hand and said without doubt.

"Then..." The director of respiratory medicine hesitated slightly.

"I'll contact Director Bai." Lu Gang reassured the director of the Department of Respiratory Medicine.

Although the director of the Department of Respiratory Medicine didn't believe it, the "experts" in the hospital put forward their opinions, and he had no better way, so he had to try it out.

She went to work, Lu Gang called Director Bai and then took Ji Xiang to a secluded place.

"Doctor Xiaoji, I don't think so, but now there is no other explanation except that Bai Xintong's shell blocks the patient's airway. What do you think of this matter?"

Lu Gang didn't care about his face, and asked very straightforwardly.

"One pill is not enough, what about two pills?" Ji Xiang said.

"!!!"

"The pressure of the ventilator is relatively high. The more you blow it, the more it will cause the affected side to be blocked and more dead. If there is only one shell, it will not be so bad. If two shells appear together with the shell, it will probably lead to the current situation. .”

"But the probability of accidental inhalation of two pills at the same time is too low."

"Not at the same time." Ji Xiang interrupted Lu Gang, "I guess it's probably caused by two different aspirations."

Lu Gang remained silent. Even so, the probability of such a thing happening is really not high.

"The patient has a history of cerebral infarction, has a certain degree of swallowing dysfunction and has been bedridden for a long time. If the care is not proper, aspiration is easy to occur.
He may have other drugs at the same time—for example, Divanrod and others strayed into the airway, but since all of them can be dissolved, only the shell of Baixintong was found in the airway.”

"Although the possibility of two Baixin shells blocking the airway is not high, we still need to take a look."

"Watching the film, I also feel that there is a problem." Lu Gang pondered.

"Try it." Ji Xiang smiled and encouraged Lu Gang.

Lu Gang was stunned, it seemed to be reversed, he should be the one who encouraged Ji Xiang, a clinical rookie, how could he encourage himself!
However, I have been in the medical team for a while, and Lu Gang is more or less used to Ji Xiang's way of talking.

Habit is a terrible behavior, which subtly makes everything that is irrational become logical.

"Then I'll try it." Lu Gang said.

The two went back and waited for a while. The director of the Department of Respiratory Medicine came back with a signature sheet and began to prepare bronchoscopy equipment.

Because the patient is inconvenient to move and there are many machines hanging on, she directly pushes the simple bronchoscope in.

First, the patient is given local anesthesia with tetracaine, and then the director of the Department of Respiratory Medicine passes the bronchoscope through the patient's nasal cavity to the pharynx, passes through the glottis, and sends it down a little bit into the main airway.

The patient had a lot of sputum, and he sucked the sputum while walking.

"Director Tang, how did you explain to the patient's family?" Lu Gang didn't do anything, his hands-on ability was almost zero, and he was only proficient in theory and diagnosis.

So Lu Gang looked at the screen of the bronchoscope and chatted with the director of respiratory medicine.

"I didn't dare to say that there was a foreign body in the patient's airway. If there was no foreign body, it would be difficult to explain. I just said that the bronchoscope was used to suck out all the blocked sputum."

The sound of the sputum suction tube made Jixiang a little uncomfortable, as if the tube was stuck in his oropharynx, causing him to feel flustered and short of breath, his blood oxygen saturation dropped sharply, and he even had a vague altitude sickness.

"It has to be a veteran." Lu Gang pretended to be relaxed and smiled.

"It's not you, but you have to have the shell of Baixintong, and you need to do a bronchoscopy." The director of the Department of Respiratory Medicine complained, while paying attention to the patient's blood oxygen saturation while doing the bronchoscopy.

If the blood oxygen saturation drops suddenly, it may be necessary to stop the operation.

But the "accident" still happened - as the bronchoscope in the hands of the director of the Department of Respiratory Medicine went down, a shell of Bai Xintong was "wrapped" by respiratory secretions and appeared in the surgical field.

"!!!" The director of the Department of Respiratory Medicine was horrified, "Old Lu, there really is!"

"Let me see, let me see!" Lu Gang leaned over and took a look.

As expected, Lu Gang suddenly settled down, and his demeanor was full of a senior doctor.

"I'll just say it."

The director of the Department of Respiratory Medicine stopped nagging, and took out Bai Xintong's shell with an instrument, and then he let out a sigh of relief.

"Continue." Lu Gang said.

"It's been taken out, so what are you going to do?" The director of the Department of Respiratory Medicine was about to leave as soon as she was done. She watched the ECG monitoring, and the patient's blood oxygen saturation had risen.

The director of the Department of Respiratory Medicine is quite satisfied with this, at least the patient's crisis state has been resolved.

(End of this chapter)